| 1. |
- Alexeyev, Oleg, et al.
(författare)
-
Association between the presence of bacterial 16S RNA in prostate specimens taken during transurethral resection of prostate and subsequent risk of prostate cancer (Sweden)
- 2006
-
Ingår i: Cancer Causes and Control. - Dordrecht : Kluwer Academic Publishers. - 0957-5243 .- 1573-7225. ; 17:9, s. 1127-1133
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To study bacterial 16S RNA in archival prostate samples from 352 patients with benign prostate hyperplasia (BPH) and evaluate whether the presence of bacterial DNA was different in those who later developed prostate cancer (n = 171) and in the matched controls that did not progress to cancer (n = 181).Methods: 16S DNA PCR followed by cloning and sequencing the positive samples.Results: In 96/352 (27%) of the prostate tissue specimens 16S RNA were detected. Sequence analysis revealed Propionibacterium acnes as the predominant microorganism (23% of 16S RNA positive patients). The second most frequent isolate—Escherichia coli was found in 12 (12%) patients. The other isolates included Pseudomonas sp. (3 patients), Actinomyces sp. (2), Streptococcus mutans (1), Corynebacterium sp. (2),Nocardioides sp. (1), Rhodococcus sp. (1) Veillonella sp. (2). In P. acnes positive samples 62% exhibited severe histological inflammation versus 50% in the bacteria-negative group (p = 0.602). The presence of P. acnes in the prostate was associated with prostate cancer development (OR 2.17, 95% CI 0.77–6.95).Conclusions: This study has revealed P. acnes as the most common bacteria in the prostate in BPH. Further studies are needed to clarify its role in contributing to the development of prostatic inflammation and prostate cancer.
|
|
| 2. |
- Bergh, Camilla, et al.
(författare)
-
30-day and 1-year mortality after skeletal fractures: a register study of 295,713 fractures at different locations
- 2021
-
Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 92:6, s. 739-745
-
Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Few studies have reported the mortality rate after skeletal fractures involving different locations, within the same population. We analyzed the 30-day and 1-year mortality rates following different fractures. Patients and methods - We included 295,713 fractures encountered in patients 16-108 years of age, registered in the Swedish Fracture Register (SFR) from 2012 to 2018. Mortality rates were obtained by linkage of the SFR to the Swedish Tax Agency population register. The standardized mortality ratios (SMR) at 30 days and 1 year were calculated for fractures in any location and for each of 27 fracture locations, using age- and sex-life tables from Statistics Sweden (www.scb.se). Results - The overall SMR at 30 days was 6.8 (95% CI 6.7-7.0) and at 1 year 2.2 (CI 2.2-2.2). The SMR was > 2 for 19/27 and 13/27 of the fracture locations at 30 days and 1 year, respectively. Humerus, femur, and tibial diaphysis fractures were all associated with high SMR, at both 30 days and 1 year. Interpretation - Patients sustaining a fracture had approximately a 7-fold increased mortality at 30 days and over 2-fold increased mortality at 1 year as compared with what would be expected in the general population. High mortality rates were seen for patients with axial skeletal and proximal extremity fractures, indicating frailty in these patient groups.
|
|
| 3. |
- Bergh, Camilla
(författare)
-
Aspects of bone quality and risk assessments in fracture and elective orthopaedic patients
- 2021
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Bone quality, bone strength, and bone remodelling are important in many orthopaedic conditions and can have an impact on fracture incidence, bone healing, implant failure, and different outcome aspects. There is relatively sparse information on fracture incidence and mortality both for all fractures compiled and for some of the individual fracture locations. In elective orthopaedic surgery, systematic screening for bone quality is rarely performed today. Aim: The aim of the constituent studies of this thesis was to investigate epidemiology and mortality in patients sustaining different types of fractures in relation to age and gender and, furthermore, to investigate preoperative bone quality in a group of elective orthopaedic patients. Methods: In studies I, III, and IV, data collected in the Swedish Fracture Register (SFR) were combined with data from Statistics Sweden (SCB) and the Swedish Tax Agency population register to calculate incidence and mortality for all fractures.locations. The SFR data were divided into 27 anatomical locations. Incidence curves based on age and gender were calculated and grouped based on visual appearance (Study I). The standardized mortality ratio (SMR) was calculated for 30-day and 1-year mortality as the ratio between observed and expected mortality, (Studies III and IV). In study I, the catchment area was Gothenburg and surrounding municipalities, included 23,917 individuals sustaining 27,169 fractures during the 2015–2018 period. Studies III and IV included data on 295,713 fractures registered during the 2012–2018 period throughout Sweden. In study II, 65 patients undergoing elective surgery for lumbar spinal stenosis (LSS) and 53 patients with hip osteoarthrosis (HOA) undergoing hip arthroplasty all underwent dual-energy X-ray absorptiometry (DXA) measurement of the femoral neck (FN) and in three projections/areas of the lumbar spine before surgery. The LSS patients also filled out the Fracture Risk Assessment Tool (FRAX) questionnaire and the results were compared with those of the DXA investigations. Results: The fracture incidence was found to be 1229 fractures/105 person year, with the highest incidences for the wrist (201/105 ), proximal femur (181/105 ), ankle (127/105 ), proximal humerus (101/105 ), and metacarpals (89/105 ) (Study I). Women sustained 64.5% of the fractures, 9.2% of which were registered as high-energy trauma and 2.3% as open fractures. Seven fracture incidence distribution groups were created (Study I). DXA measurements in LSS patients demonstrated large variations in BMD in the different projection with the lowest values for lateral projection of the vertebrae. No major differences regarding BMD were seen between the two elective patient groups (spine and hip patients). With DXA measurement of the lateral spine 71% of the spinal stenosis patients had less than -2.5 in T-score, while the FRAX questionnaire identified only 40% of these patients as high-risk patients.(Study II). The overall SMR at 30 days was found to be 6.8 (95% CI 6.7–7.0) and at one year 2.2 (95% CI 2.2–2.2) (study III). For 19/27 and 13/27 of the fracture locations at the two time points, respectively, the SMR was >2. Humerus, femur, and tibial diaphysis fractures were all associated with high SMR at both time points. For the oldest age group, 22 out of 27 fracture locations had an SMR ≥2 at 30 days (Study IV). Fractures of the femur (i.e., proximal, diaphysis, and distal) and humerus diaphysis were among the fractures associated with the highest mortality rates and SMRs within each age group. Conclusions: Overall fracture incidence varied markedly with age and gender in different locations. The incidence curves suggested that proximal tibia fractures and ankle fractures in women, in addition to established osteoporosis-related fractures, are mainly osteoporosis related. Osteoporosis/osteopenia was common in the elective spine surgery patients, however and FRAX evaluation could not replace DXA measurement of the spine. Regardless of age, any type of femur fractures and humerus diaphysis fractures were associated with increased mortality. The high mortality rates seen for elderly patients with axial skeletal and proximal extremity fractures, indicate frailty in these patient groups.
|
|
| 4. |
- Bergh, Camilla, et al.
(författare)
-
Fracture incidence in adults in relation to age and gender: A study of 27,169 fractures in the Swedish Fracture Register in a well-defined catchment area
- 2020
-
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15
-
Tidskriftsartikel (refereegranskat)abstract
- © 2020 Bergh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Studies on fracture incidence have mostly been based on retrospectively registered data from local hospital databases. The Swedish Fracture Register (SFR) is a national quality register collecting data prospectively on fractures, at the time of care-seeking. In the present study the incidence of all different fractures, regardless of location, in adults’ > 16 years treated at the only care provider for patients with fractures within a catchment area of approximately 550,000 inhabitants, during 2015–2018 are described. Age, gender, and fracture location (according to AO/OTA classification) was used for the analyses and presentation of fracture incidences. During the 4-year study period, 23,917 individuals sustained 27,169 fractures. The mean age at fracture was 57.9 years (range 16–105 years) and 64.5% of the fractures occurred in women. The five most common fractures accounted for more than 50% of all fractures: distal radius, proximal femur, ankle, proximal humerus, and metacarpal fractures. Seven fracture incidence distribution groups were created based on age- and gender-specific incidence curves, providing visual and easily accessible information on fracture distribution. This paper reports on incidence of all fracture locations based on prospectively collected data in a quality register. The knowledge on fracture incidence related to age and gender may be of importance for the planning of orthopaedic care, involving both in- and out-patients as well as allocating surgical resources. Further, this might be useful for organizing preventive measures, especially in countries with similar socioeconomic structure and fracture burden.
|
|
| 5. |
- Bergh, Camilla, et al.
(författare)
-
Increased risk of revision in patients with non-traumatic femoral head necrosis.
- 2014
-
Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 85:1, s. 11-17
-
Tidskriftsartikel (refereegranskat)abstract
- Background and purpose Previous studies of patients who have undergone total hip arthroplasty (THA) due to femoral head necrosis (FHN) have shown an increased risk of revision compared to cases with primary osteoarthritis (POA), but recent studies have suggested that this procedure is not associated with poor outcome. We compared the risk of revision after operation with THA due to FHN or POA in the Nordic Arthroplasty Register Association (NARA) database including Denmark, Finland, Norway, and Sweden. Patients and methods 427,806 THAs performed between 1995 and 2011 were included. The relative risk of revision for any reason, for aseptic loosening, dislocation, deep infection, and periprosthetic fracture was studied before and after adjustment for covariates using Cox regression models. Results 416,217 hips with POA (mean age 69 (SD 10), 59% females) and 11,589 with FHN (mean age 65 (SD 16), 58% females) were registered. The mean follow-up was 6.3 (SD 4.3) years. After 2 years of observation, 1.7% in the POA group and 3.0% in the FHN group had been revised. The corresponding proportions after 16 years of observation were 4.2% and 6.1%, respectively. The 16-year survival in the 2 groups was 86% (95% CI: 86-86) and 77% (CI: 74-80). After adjusting for covariates, the relative risk (RR) of revision for any reason was higher in patients with FHN for both periods studied (up to 2 years: RR = 1.44, 95% CI: 1.34-1.54; p < 0.001; and 2-16 years: RR = 1.25, 1.14-1.38; p < 0.001). Interpretation Patients with FHN had an overall increased risk of revision. This increased risk persisted over the entire period of observation and covered more or less all of the 4 most common reasons for revision.
|
|
| 6. |
- Bergh, Camilla, et al.
(författare)
-
Mortality after Sustaining Skeletal Fractures in Relation to Age
- 2022
-
Ingår i: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 11:9
-
Tidskriftsartikel (refereegranskat)abstract
- Age-related mortality across fractures in different anatomical regions are sparsely described, since most studies focus on specific age groups or fracture locations. The aim here was to investigate mortality at 30 days and 1 year post-fracture within four different age groups. All patients >= 16 years registered in the Swedish Fracture Register (SFR) 2012-2018 were included (n = 262,598 patients) and divided into four age groups: 16-49, 50-64, 65-79, and >= 80 years of age. Standardized mortality ratios (SMR) at 30 days and 1 year after sustaining a fracture were calculated using age- and gender-specific life tables from Statistics Sweden for each of the 27 fracture locations in the four age groups. Absolute mortality rates for the youngest age group for all locations were below 1% and 2% at 30 days and 1 year, respectively. For the patients in the two oldest age groups (65 and older), mortality rates were as high as 5% at 30 days and up to 25% at 1 year for certain fracture locations. For younger patients a few localizations were associated with high SMRs, whereas for the oldest age group 22 out of 27 fracture locations had an SMR of >= 2 at 30 days. Fractures of the femur (proximal, diaphysis, and distal) and humerus diaphysis fractures were among the fractures associated with the highest mortality rates and SMRs within each age group. Moderately high SMRs were further seen for pelvic, acetabulum, spine, and tibia fractures within all age groups. Regardless of age, any type of femur fractures and humerus diaphysis fractures were associated with increased mortality. In the oldest age groups, about twice as many patients died within 1 year after sustaining a fracture in almost any location, as compared with the expected mortality rates, whereas in the youngest age group only fractures in a few locations were associated with a high SMR.
|
|
| 7. |
- Bergh, Camilla, et al.
(författare)
-
Preoperative dual-energy X-ray absorptiometry and FRAX in patients with lumbar spinal stenosis
- 2018
-
Ingår i: Journal of Orthopaedic Surgery and Research. - : Springer Science and Business Media LLC. - 1749-799X. ; 13
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundOsteoporosis implies an increased risk of complications after orthopedic surgery. For the mostly elderly group of patients undergoing lumbar spinal stenosis surgery (LSS), it is important to include skeletal health evaluation in the preoperative planning. The aim of this study was to assess spine and femoral neck (FN) bone mineral density (BMD) in LSS patients and to evaluate whether the World Health Organization (WHO) fracture risk assessment tool (FRAX) can identify patients with reduced BMD levels in the spine.MethodsThe study involved 65 LSS patients and 53 patients with hip osteoarthritis (HOA) for comparison. BMD was measured with dual-energy X-ray absorptiometry (DXA) in the lumbar spine in three projections: anterior-posterior (AP), lateral and lateral-mid (the mid-portion of the vertebrae), and FN. The LSS patients filled out the FRAX questionnaire.ResultsIn the LSS group, 43% of the women and 8% of the men were classified as being osteoporotic/osteopenic by AP spine measurement. The corresponding proportions using the lateral spine T-score -2.5 were 87% and 57%, respectively, and 82% and 53%, respectively, for the FN. The FN BMD T-score was significantly lower in the LSS group compared with the HOA group. The FRAX questionnaire identified 40% of the LSS patients with a moderate/high risk of sustaining an osteoporotic fracture within 10years, with or without simultaneous FN BMD, while 71% of these patients were classified as being osteoporotic with DXA lateral spine measurement.ConclusionIt is common with osteoporosis/osteopenia in patients undergoing spine surgery, and the identification may influence the surgical treatment why the evaluation of BMD is important preoperatively. FRAX evaluation could not replace DXA measurement of the spine regarding the identification of osteoporosis patients in the preoperative planning phase.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Bovinder Ylitalo, Erik, et al.
(författare)
-
Marked response to cabazitaxel in prostate cancer xenografts expressing androgen receptor variant 7 and reversion of acquired resistance by anti-androgens
- 2020
-
Ingår i: Prostate. - : Wiley. - 0270-4137 .- 1097-0045. ; 80:1, s. 214-224
-
Tidskriftsartikel (refereegranskat)abstract
- Background Taxane treatment may be a suitable therapeutic option for patients with castration-resistant prostate cancer and high expression of constitutively active androgen receptor variants (AR-Vs). The aim of the study was to compare the effects of cabazitaxel and androgen deprivation treatments in a prostate tumor xenograft model expressing high levels of constitutively active AR-V7. Furthermore, mechanisms behind acquired cabazitaxel resistance were explored. Methods Mice were subcutaneously inoculated with 22Rv1 cells and treated with surgical castration (n = 7), abiraterone (n = 9), cabazitaxel (n = 6), castration plus abiraterone (n = 8), castration plus cabazitaxel (n = 11), or vehicle and/or sham operation (n = 23). Tumor growth was followed for about 2 months or to a volume of approximately 1000 mm(3). Two cabazitaxel resistant cell lines; 22Rv1-CabR1 and 22Rv1-CabR2, were established from xenografts relapsing during cabazitaxel treatment. Differential gene expression between the cabazitaxel resistant and control 22Rv1 cells was examined by whole-genome expression array analysis followed by immunoblotting, immunohistochemistry, and functional pathway analysis. Results Abiraterone treatment alone or in combination with surgical castration had no major effect on 22Rv1 tumor growth, while cabazitaxel significantly delayed and in some cases totally abolished 22Rv1 tumor growth on its own and in combination with surgical castration. The cabazitaxel resistant cell lines; 22Rv1-CabR1 and 22Rv1-CabR2, both showed upregulation of the ATP-binding cassette sub-family B member 1 (ABCB1) efflux pump. Treatment with ABCB1 inhibitor elacridar completely restored susceptibility to cabazitaxel, while treatment with AR-antagonists bicalutamide and enzalutamide partly restored susceptibility to cabazitaxel in both cell lines. The cholesterol biosynthesis pathway was induced in the 22Rv1-CabR2 cell line, which was confirmed by reduced sensitivity to simvastatin treatment. Conclusions Cabazitaxel efficiently inhibits prostate cancer growth despite the high expression of constitutively active AR-V7. Acquired cabazitaxel resistance involving overexpression of efflux transporter ABCB1 can be reverted by bicalutamide or enzalutamide treatment, indicating the great clinical potential for combined treatment with cabazitaxel and anti-androgens.
|
|
